The majority of acute cerebrospinal fluid nasal or ear leaks caused by skull base fractures can be cured by non-surgical treatment, and only a small number of cases that do not heal for more than 3-4 weeks are considered for surgical treatment. Non-surgical treatment: Generally, the head is placed 30° higher on the affected side, so that the brain tissue sinks at the leaky hole to facilitate the adhesion and healing. At the same time, the nasal cavity or ear canal should be cleaned, avoid blowing the nose, coughing and forceful breath-holding, keep the stool open, limit the amount of fluid intake, and give appropriate drugs to reduce cerebrospinal fluid secretion, such as acetazolamide, or use mannitol diuretic dehydration. If necessary, lumbar perforation of the cerebrospinal fluid can be performed to reduce or stop the leakage and to allow the leak to heal. About 85% of patients with cerebrospinal fluid nasal leakage and ear leakage are cured after 1-2 weeks of palliative care. Surgical treatment: Only 2.4% of traumatic cerebrospinal fluid leaks require surgical treatment, and cerebrospinal fluid leak repair is required only when the leak is prolonged or recurs several times after self-healing. 1, cerebrospinal fluid nasal leak repair: preoperative positioning of the leak hole must be carefully done, the method has been as described above. After determining the location of the leak, craniotomy with frontal bone flaps on the affected side or bilaterally is feasible. First, the dura should be carefully separated from the posterior wall of the frontal sinus, orbital apex, pterygoid crest, or sieve plate area according to the preoperative suspected site by epidural exploration. Where the leak is located, the dura is often thickened and caught in the fracture suture, so the leak should be separated and picked down as close to the skull as possible without enlarging the leak. The soft tissue at the skull breach is electrocauterized and pushed into the bone suture, or into the sinus cavity if it is a sinus wall, and the skull fracture is closed with bone wax or medical gel. Then, closely suture or repair the broken hole on the dura mater. 2, cerebrospinal fluid ear leak repair: the specific site of the ear leak must be identified before surgery. If the fracture of the middle cranial fossa involves the tympanic cap, so that the cerebrospinal fluid directly enters the middle ear cavity and flows to the external ear canal through the ruptured ear drum, it is a vagus external ear leak; if the fracture of the posterior cranial fossa involves the vagus, so that the subarachnoid cavity communicates with the middle ear cavity, it is a vagus inner ear leak. The surgical approach is different between the two. The temporo-occipital flap can be used to repair middle fossa otolacrimal leaks by making an arcuate temporal flap centered on the external mastoid with the base of the flap as close to the middle fossa as possible. The epidural approach is followed in front of the rock bone to detect any leakage in the tympanic cap area. If it is negative, it should be replaced by subdural exploration. Do not separate too much medially into the middle fossa to avoid damaging the superficial rock nerve, trigeminal nerve, middle meningeal artery and cavernous sinus. When a leak is found, the method of sealing and repair is as described above. If the fracture is behind the rock bone, this approach can still take into account the posterior fossa, i.e., the canopy is cut along the posterior edge of the rock bone crest, taking care not to damage the superior rock sinus and sigmoid sinus. The leaky hole behind the rock bone can be explored by turning the canopy over, which is mostly located slightly lateral to the internal auditory canal and is easily identified by the presence of cerebellar tissue and arachnoid protrusion. The leaky hole is difficult to patch and is usually plugged with muscle or fascial sheet dipped in medical adhesive, which is then fixed with a tipped muscle cover. After surgery, the scalp layers are tightly sutured and no drainage is put in place. After the operation, the intracranial pressure should be reduced and strong antibacterial treatment should be given. In addition, repair of the leak behind the rock bone can also be performed via the inferior occipital cranial approach for the vagus inner ear leak. 3, cerebrospinal fluid wound leak (skin leak): first of all, non-surgical treatment should be carried out carefully, vigorously control infection, and at the same time, beyond the wound leak (>6cm), the scalp should be completed with the benefit of ventriculoperineal puncture, or continuous drainage by contralateral ventriculoperineal puncture, or drainage of cerebrospinal fluid by lumbar puncture, adjusting the drainage flow until the leak stops overflowing, which should not be too much. If there is no acute inflammation at the wound leak, the necrotic part of the skin margin can be cut out and then sutured in full. If there is acute inflammation, the pus and decaying tissue should be removed, cleaned and disinfected, and the dressing should continue to be changed to benefit the healthy growth of granulation tissue. After the acute inflammation is controlled, the suture should be sutured again or seeded on the granulation surface to eliminate the wound and close the leak.